The use of Glasgow Coma Scale in injury assessment : a critical review

Zuercher, Mathias and Ummenhofer, Wolfgang and Baltussen, Anja and Walder, Bernhard. (2009) The use of Glasgow Coma Scale in injury assessment : a critical review. Brain injury, Vol. 23. pp. 371-384.

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Official URL: http://edoc.unibas.ch/dok/A6005266

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PRIMARY OBJECTIVE: Patients with brain injuries are assessed using the Glasgow Coma Scale (GCS). This review evaluates the use of GCS scoring in medical literature and identifies the reasons for inaccuracy. LITERATURE SELECTION AND CRITICAL APPRAISAL: Pubmed and ISI Web of Knowledge SM were searched using specific keywords. The authors critically appraised the current state of GCS scoring, GCS definitions, the time and frequency of assessment, confounders, GCS reporting and GCS assessment schemes. MAIN OUTCOME AND RESULTS: More than 90% of the publications using GCS scoring cite the 14-item GCS rather than the 15-item GCS. The timing of the initial GCS assessment is inconstant. GCS components are seldom utilized, contributing to the loss of information. Confounders are often not reported and, if they are, not in a standardized manner. The order of the GCS components is not consistent. CONCLUSIONS: The current inconsistent and inappropriate use of GCS diminishes its reliability in both a clinical and a scientific context. A consensus statement is needed to correct this situation. Citing the correct references, early and repeated GCS assessments at defined intervals, standardized reporting of confounders and GCS component plus sum scores, and the utilization of a uniform assessment scheme are recommended.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
UniBasel Contributors:Ummenhofer, Wolfgang and Zürcher, Mathias
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Taylor & Francis
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:01 Mar 2013 11:14
Deposited On:01 Mar 2013 11:13

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